Ikigai and Illness: A Guide to Living Fully with Purpose, Meaning, and Joyful Moments

Trudy Boyle

Trudy Boyle is the current director of the ToDo Institute’s initiative on Living Fully with Illness. She has been studying, writing, and teaching the principles of Living Fully with Illness, for three decades. She is also the former program director of Wellspring Calgary, a large community-based Cancer Resource Center in Calgary, Canada, and continues to play an active role in this community. Trudy’s ikigai is her meaningful and fulfilling work along with the many adventures she shares with her grandchildren.

In this small booklet, my purpose is to offer encouraging words, skills for living fully with illness, and an important reminder that you can do this. You have what it takes to rise to the occasion.

This booklet is an invitation to sit together for a while and examine a perspective on how we can coexist with illness and all the uncertainty that accompanies it. Let’s peek through a window into what matters most to you and what you can do now to make it happen.

In this book, Trudy inspires people by sharing how they can live a meaningful life amidst the struggles that they are facing; she reminds people that they should not be defined by their illnesses, and not to limit themselves on what they can do.

Introduction to ikigai

Ikigai is a Japanse word. The combination of iki and gai means, respectively, to live, and meaning/value/purpose. It essentially translates into something like, “a reason to get up in the morning.”

According to Tokyo writer, Yukari Mitsuhashi, the Japanese people believe that the traditional meaning is closer to the purpose of your everyday life… more like the sum of small joys in everyday life, resulting in a more fulfilling life, as a whole.

Ikigai is really like the sum of small joys in everyday life. In my interview with Ken Mogi, he stated that ikigai is all about making these small actions into pleasurable, rewarding experiences, and I agree that we can feel ikigai even in the simple things, it can be a daily activity that we enjoy doing – anything that gives us joy.

Ikigai - doing something meaningful and purposeful every day

I like how Trudy defines her ikigai as something built around the concept of hospitality and cheerfulness, something that she finds purpose and great joy in, different from the Western interpretation of ikigai that it is something related to work or money.

She also mentioned her friend named John who boiled his ikigai down to what he called The Four F’s: Family, Friends, Faith, & Fun. He said YES to things that fell into these categories, which just goes to show that ikigai is not about having lofty goals, it is more about the things that keep us going; the meaningful relationships that we build that motivate us especially during trying times.

What is doable in the here and now

When we are newly diagnosed with a serious illness and going through treatment, this is the time to focus on short-term goals that we can do every day. We look at things we can do today with our current circumstances. What is doable in the here and now? 

I learned, firsthand, the practical application of ikigai during my cancer treatment. I discovered a reason, beyond my treatment, to get up every morning and go looking for the things in my life that were working. 

When we pay attention to the world around us including our own experience, we start to notice under what conditions we actually feel better or obtain a mental reprieve from our worries. Perhaps it is a hobby, music, gardening, being in nature, volunteer work and so on. Our illness is still there, but we discover there are things we can do to influence our state of mind and heart. And we purposefully do them.

By being present and mindful of our surroundings, we begin to understand ourselves better and know exactly what we want in life. We can find sources of ikigai in our daily lives, we just need to pay attention to the things that give us meaning in our daily living. Sometimes we become fixated on the future that we forget to appreciate the things that we have. 

Ikigai changes with changing circumstances

Trudy recalls a time when she thought of what would she regret not having done if only she had two years left to live. Then the answer came to her clearly: she would regret not getting to know her two youngest grandchildren who lived 3500km away in Ottawa.

The call of ikigai doesn’t come once and for all. And when it announces itself, there is always something to do. As circumstances changed, new opportunities presented themselves. 

Ikigai is something that changes over time, and it depends on what life situation we are in. And ikigai is not something that we look for, it is something that occurs to us naturally – we just feel it. 

In the vast majority of cases, illness does not prevent us from doing something meaningful with our time, with our lives. Remember that the traditional meaning of ikigai is primarily about the purpose of our everyday, ordinary lives. And we may find that living with purpose and meaning is part of the way we heal ourselves. Not just medically, but also psychologically and spiritually.

Without suffering, we may not fully experience the depths of ikigai. We find purpose in life through our personal challenges and battles, our minor inconveniences and life-confronting problems, and through these life difficulties, we come to appreciate our lives more.

Learn to effectively co-exist with uncertainty, anxiety, and fear of death

As we gain equilibrium, we discover, with the right information, that it is possible to co-exist with this uncertainty, anxiety, and fear of death and not go crazy.

The truth is these things we imagine are not happening now. This is where we can use our attention to see what is happening… None of the things we are worrying about are actually happening now. 

We have been taught that in order to live well we need to fix our fears, anxiety, and uncertainty. The power of Living Fully with Illness teaches practical skills so that we don’t have to fix anything. Rather we can learn to co-exist with these feelings and still live meaningful, active and purposeful lives with many joyful moments. 

This reminds me of my interview with Gregg Krech. Gregg shared that one of the distinctive features of Japanese psychology, particularly Morita therapy, is the idea that feelings are uncontrollable; it teaches people to accept their emotions, and that it is possible to coexist with their unpleasant feelings, rather than try to get rid of them. 

It is learning to live with our unpleasant emotions and trying to focus more on the things that make us feel alive.

Working with Your Attention

What we pay attention to becomes our experience of life.

When your interior world needs a break from darkness, gloom, and fears of what might happen, notice what you are paying attention to. Ask yourself this question: is what I am paying attention to right now helpful?

The more you observe with conscious attention, the more your world lights up.

In my podcast conversation with Dr. Katharina Stenger, we discussed how working on your attention is like having an ikigai mindset. According to Rina, an ikigai mindset makes people more active, it can draw people out of a passive state of suffering, boredom, and indifference; it trains their awareness, imagination, and optimism. So having an ikigai mindset is essential for us to move forward in life.

Controlling what is Controllable

Arugamama is one of my favorite Japanese words. It means an acknowledgment and acceptance of what is, even when “what is” may be something we do not like and cannot control… But acceptance doesn’t mean passivity. Rather, it is more accurately described as an active acceptance. I like to say that it is the first step towards implementing the changes that can be changed.

Arugamama, which literally translates to ‘as is it’, is a word I learnt from my podcast guest, Dr. Holly Sugg. Having arugamama is to  understand the true nature of things; accepting things as they are, and to live life as it is. To appreciate ikigai fully, it is crucial to accept that there are things that we have no control over, and we must learn to live with them.

Acknowledging death

When we acknowledge the inevitability of death, and we don’t know our expiry date, what might we do in the waiting room? This uncertainty can act like a prompt to remind us that we have no time to lose. Besides getting our affairs in order, it is also time to take stock of our lives and see what changes we want to make, while we can. Another gift we can all give to our loved ones and to ourselves is to live as well as we can with outstretched arms, and not lose out on the chance to celebrate our ordinary lives, while we are here.

Preparing for death is more than getting our affairs in order. It is doing what we can do to get our lives in order. It is about taking action, small steps, even when not in the mood. It is doing our best to live each day as well as we can until we can’t.

Let’s strive for being as alive as possible, until our last breath.

I believe that is what ikigai is all about, making the most of our everyday lives, finding purpose and meaning in life amidst the trials that we encounter. It is all about building on our meaningful relationships and experiences, rather than wasting our time on things that do not really matter.

Empowering actions we can take

An important part of Living Fully with Illness is to be active and try new things. None of us can count on tomorrow and this is one reason why Living Fully with Illness is present-centered. We don’t want to waste our time while we have the chance to live. 

The ordinary everyday moments are where we have the best chance to live well and make an impact on ourselves and our loved ones. And there are practices that can help us.

One practice that can help us is play. In my interview with Dr. Suzy Ross, we discussed the importance of play. According to Dr. Ross, play and leisure can transform people’s lives, and we can find ikigai in activities or experiences that make people feel that their lives are moving forward.

Another important part Trudy mentions is by making others laugh, she states: “Humor is a hallmark of Living Fully with Illness… Humor therapy is built into this unique approach, alongside conventional medicine.” 

Laughter or having a good laugh is also vital to our well-being. In my interview with Dr. Dean Fido, he shared that ikigai researchers tried to implement interventions to explore potential reductions in depression, stress, and anxiety; one of it these interventions was laughter psychology. The researchers developed a program where laughter therapy was entwined with life meaning, life goals, and people reflecting on themselves.

Add a Creative Touch to Your Day

When we absorb ourselves in the doing of art, music, writing, poetry, calligraphy, playing/learning an instrument, listening to music, blogging, photography, quilting, storytelling, and so on, we stimulate the healing response.

Engaging with various art forms can also be helpful for our well-being. In my interview with Rie Takeda, she shared that she conducts mindfulness calligraphy to help therapists rehabilitate people with neurological injuries and children with autism. She witnessed many cases where the mindfulness calligraphy made a positive impact on the patients’ conditions: they showed improvements in their concentration and increase in mobility and flexibility.


When we go through difficulties in life, one of our responsibilities is to then help others who are lost and struggling. My hope here. Paradoxically, in doing so, we help ourselves.

May you keep a lookout for your ikigai - those reasons to get up in the morning, and may you live an active and meaningful life with many moments of joy, in the loving company of good friends and family.

Overall I would say that this is an insightful and helpful read, as it gives inspiration especially to those who are having a hard time and battling with illness. Trudy teaches us that we can co-exist with illness or whatever life challenges we are facing. We might be struggling, but still, we can find sources of ikigai that will help motivate us to keep moving forward in life.

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